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Financial Improvement Consulting 2020
Performance Improvement in a Time of Upheaval

author - Warren Whitford
Warren Whitford
author - Lois Krotz
Lois Krotz
November 17, 2020 | Read Time: 6  minutes

Possibly the only constant in healthcare is that money is tight, and the COVID-19 pandemic has only tightened margins further by limiting health systems’ revenue for an undetermined amount of time. In this perfect storm of financial pressures, many organizations have turned to consulting firms for guidance to improve their financial performance. This report examines nine such firms, including the types of work they do and how well they deliver the financial outcomes clients need and expect. 


This report is based on interviews with a sample of firms' current or recent clients. As a result, it is not necessarily comprehensive of all work a firm may do in the arena of financial improvement consulting.

Most Common Type of Work: Financial Operations Optimization

The umbrella of financial improvement consulting covers a number of different focus areas. As a whole, respondents most often undertake financial operations optimization work (labor or non-labor focused). These more expansive (and thus expensive) engagements tend to also see higher client expectations and greater complexity. The highest satisfaction with outcomes tends to come from engagements in areas with narrower focus, like strategic risk services and HIM. Whether financial improvement consulting engagements are undertaken piece by piece or in a more comprehensive manner, organizations report that when they have successful engagements, they tend to continue a long-term relationship with their firm and ultimately work with them across multiple areas.

outcome ratings types of financial improvement consulting work

Area Definitions

Revenue Cycle Transformation

Comprehensive changes to the way charges are captured, billed, and reimbursed in order to maximize revenue. Includes major end-to-end assessment and overhaul of the entire revenue cycle (front to back).

Financial Operations Optimization (Non-Labor Focused)

Assessments and upgrades in specific areas to accelerate cash flow, increase top-line revenue, improve efficiency, decrease cost, and reduce avoidable losses. Also may include any targeted revenue cycle improvement.

Financial Operations Optimization (Labor Focused)

Structural changes to reduce cost of labor (i.e., staffing levels, wage rates) and to modify processes and introduce automation to reduce the amount of labor required. Also may involve refining elements of the supply chain to reduce expenses.

Clinical Effectiveness

Modification in clinical processes and tools (may include implementing new tools) in clinical settings to help maximize revenue and/or lower costs.

Business Model Transformation

Improvement in the way services are configured, priced, and marketed.

Supply Chain Redesign

Modification of practices around purchasing and material management to lower costs and/or optimize utilization of supplies.

Operating Room Improvement

Specific to surgical units, improvement of revenue capture and reduction of costs.

Healthcare Information Management (HIM)

Optimization of the functionality and/or usability of HIM systems and processes.

Ambulatory Improvement

Specific to clinics and other ambulatory settings, improvement of revenue capture and reduction of costs.

Strategic Risk Services

Assessment and optimization of policies, practices, and systems that affect financial risk.

PwC and Accenture Stand Out as Reliable High Performers

Healthcare organizations seeking financial improvement consulting often have urgent needs and high expectations, so they need services firm partners who consistently deliver results. The firms who are most consistent drive high client confidence, long-term relationships, and future engagements. In this study, PwC (14 interviewed clients) and Accenture (6 interviewed clients) perform most consistently and highly overall—their least satisfied clients rate the firms just 11–12 points lower (out of 100) than their most satisfied clients. Ratings from the bottom quartile of respondents show Deloitte, Optum, and Huron are the most likely to have clients who fall through the cracks in some way and who report very low satisfaction (see next page for more insights on the latter two firms).

variation in overall performance score

Accenture, Guidehouse (Navigant) Driving Outcomes; PwC Stands Out for Both Outcomes and Money’s Worth

Financial improvement engagements are measured through concrete financial outcomes, providing a uniquely clear view of a firm’s success or failure. PwC is the only firm with standout ratings for both tangible outcomes and money’s worth. Interviewed Accenture and Guidehouse (formerly Navigant) clients also report high satisfaction with the outcomes they see. Premier clients report the financial improvement services they receive (often embedded in larger contracts) are well worth the cost; some say guidance from the firm is somewhat standardized and thus less impactful.

moneys worth vs tangible outcomes and reported outcomes

Accenture & PwC Seen as Long-Term Partners

When clients label their services firm a partner, they also indicate they are highly likely to be repeat customers. Such long-term relationships are based on a variety of factors, including how deeply the firm has come to know the client’s needs, challenges, and goals. Accenture and PwC are rated highest by interviewed clients for strength of partnership; organizations cited careful listening, proactive engagement, and responsiveness from the firms. The limited number of interviewed Chartis Group clients offer similar feedback. EY clients (limited data) describe the firm as their “go-to” option, saying EY’s expertise and flexibility foster long-term relationships.

executive involvement vs strength of partnership

Huron Clients Seek More Expertise; Optum Missing the Mark with Results

Successful engagements depend on many factors, but consultants having needed expertise is a base-level requirement. Most firms deliver well in this respect, though a few client bases mention gaps. Several Huron clients brought up staff challenges: sometimes consultants had the wrong skill sets, and sometimes recommendations were not strategic enough or lacked best practices. A few attributed expertise gaps to turnover at the firm. Optum also performs relatively poorly in the engagement execution metric. Clients who experienced issues say deliverables did not meet their needs or expectations and that the client organization was expected to drive execution rather than Optum pushing the project forward. A few Optum clients also report the firm lacked the breadth of capabilities to support all their needs. Notably, clients did mention effective analytics tools from Optum—another way to support a successful engagement. Accenture, Chartis Group, and PwC receive praise for effectively scoping customized projects and then applying a laser-like focus on the work.

engagement execution vs quality of staff

About This Report

Each year, KLAS interviews thousands of healthcare professionals about the IT products and services their organizations use. These interviews are conducted using a standard quantitative evaluation, and the scores and commentary collected are shared online in real time so that other providers and IT professionals can benefit from their peers’ experiences. To enable readers to more quickly understand high-level differences in vendor performance and give better context as to how each product compares to other offerings in the market, KLAS has organized the questions from the standard evaluation into five customer experience pillars—loyalty, operations, services, relationship, and value.

customer experience pillars

The data in this report was collected over the last 24 months; the number of unique responding organizations is given in the chart below. Only consulting engagements of at least $500,000 qualify to be included in this research.

home health and hospice solutions

What Does “Limited Data” Mean? 

Some services are used in only a small number of facilities, some firms are resistant to providing client lists, and some respondents choose not to answer particular questions. Thus a firm’s sample size may vary from question to question and may not reach KLAS’ required threshold of 6 unique respondents. When a firm’s sample size for a particular question is less than 6, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 3, no score is shown. Note that when a firm has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.

Overall scores are measured on a 100-point scale and represent the weighted average of several yes/no questions as well as other questions scored on a 9-point scale.

author - Amanda Wind Smith
Amanda Wind Smith
author - Natalie Jamison
Natalie Jamison
author - Robert Ellis
Project Manager
Robert Ellis
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.